Richman N M, Scheller A D
Pro Sports Orthopaedics, New England Baptist Hospital Bone and Joint Institute, Boston, Mass., USA.
Orthopedics. 1998 Jul;21(7):810-3. doi: 10.3928/0147-7447-19980701-12.
This case presented a 17-year-old patient with persistent complaints localized to the right patellofemoral joint. Clinical examination demonstrated increased medial translation of the patella on manual stress. In contrast to previous published reports on medial patellar subluxation, this patient had not undergone prior lateral retinacular release. Arthroscopic examination documented medial tracking of the patella as well as excess medial translation. Imbrication of the patient's lateral patellar retinaculum centralized patella tracking and diminished medial translation on stress testing as observed arthroscopically and clinically. This case illustrates that medial patellar subluxation is a subtle problem that may be overlooked in the patient presenting with patellofemoral complaints and should be included in the differential diagnosis.
该病例为一名17岁患者,持续主诉局限于右髌股关节。临床检查显示,手动施压时髌骨向内侧移位增加。与先前发表的关于髌骨内侧半脱位的报告不同,该患者此前未接受过外侧支持带松解术。关节镜检查记录了髌骨的内侧轨迹以及过度的内侧移位。对患者的外侧髌骨支持带进行重叠缝合后,髌骨轨迹集中,且在关节镜检查和临床观察的应力测试中,内侧移位减少。该病例表明,髌骨内侧半脱位是一个细微的问题,在出现髌股关节症状的患者中可能被忽视,应纳入鉴别诊断。